Consideration of dose and timing when applying interventions after stroke and spinal cord injury

Research suggests timing and dosage of interventions matter in neurorehabilitation after stroke and spinal cord injury. For stroke, more therapy doesn't always mean better results for upper body recovery, no matter when it's given. We still need to study if more therapy helps with lower body and movement recovery. For spinal cord injury, the timing, specific exercises, and spinal cord environment all play a role. Inflammation is important in deciding if an intervention will help or hurt. Retraining eccentric control during gait may be necessary.

• 1
  In stroke rehabilitation, larger amounts of upper extremity therapy did not result in better outcomes more than 6 months post-stroke.
• 2
  In spinal cord injury, early treadmill training can be harmful if inflammation is not controlled, highlighting the importance of the inflammatory microenvironment.
• 3
  Eccentric treadmill training late after spinal cord injury showed improvements in joint coordination and movement, suggesting task-specific training can be beneficial.